Ask the Professional

The words “vein stripping” strike fear into the heart of anyone with  varicose veins. The main culprit causing varicose veins, is backward flow of vein blood down the Greater Saphenous Vein (GSV) through leaky valves, following by swelling of side branches (varicosities). To effectively treat the condition, the GSV needs to be addressed first.

The current standard of care is to seal the GSV closed utilizing a heat generating device such as a laser or radiofrequency (RF) machine. Before these techniques were available—about 10-12 years ago—vein stripping was utilized. This is a surgical procedure during which the GSV is surgically removed in the operating room under anesthesia. The laser and RF procedures are much less invasive and are performed in the office under local anesthesia. Vein stripping as such is no longer common at all for the treatment of varicose veins.

The GSV is the main trunk, but the varicose veins still need to be addressed. They are typically treated in one of two ways. The veins can be injected with a chemical to seal them closed (sclerotherapy), or they can be removed through tiny 1-2mm stab incisions (phlebectomy). Not very many providers are comfortable doing the phlebectomy for multiple reasons. But, phlebectomy has several advantages over injections:

  • It is cosmetically better.
  • There are less risks of blood clot formation.
  • There is less hyperpigmentation.
  • The vein is absolutely gone at the end of the procedure.

If the veins cannot be easily seen or felt, then injections are better. Phlebectomy is not the same as vein stripping. Phlebectomy is for the tributary vessels (varicosities) and stripping is for the truncal vessel (GSV).

Although stripping is not common, sometimes it is required for complete vein care and, as a surgeon, Dr. Nellestein is comfortable offering this treatment modality when it is needed. The NVI is extremely well versed in all aspects of complete vein management including vein stripping, phlebectomy,  ultrasound guided injections, laser and radiofrequency ablation and spider vein treatments. We are the only full-time facility in NW Missouri offering all these modalities. For more information about phlebectomy or vein stripping, stop by or call Nellestein Vein Institute (816) 291-4149 for a free consultation.